Judge Strikes Down Individual Mandate in Health Reform

A federal district judge in Virginia ruled that the individual mandate portion of the Affordable Care Act (ACA) is unconstitutional, advancing challenges to the reform law one step closer to the Supreme Court.

Judge Henry E. Hudson of the U.S. District Court for the Eastern District of Virginia issued a much-awaited decision Tuesday afternoon, ruling that the section of the ACA that requires every person to buy health insurance "exceeds the constitutional boundaries of congressional power."

The Obama administration said it thinks the judge made the wrong call, and in a White House blog, Stephanie Cutter, a special projects assistant to the president, wrote that the Department of Justice is considering its appeals options.

"There have been many rulings on court cases regarding health reform and we know there will be many more," Cutter wrote. "In the end, the Affordable Care Act will prevail and the American people will enjoy the benefits of reform."

The decision is one of 15 to be issued since the law's passage but Hudson is the first judge to strike down a portion of the law.

"Despite the laudable intentions of Congress in passing a comprehensive and transformative health care regime, the legislative process must still operate within constitutional bounds," Hudson wrote.

And the individual mandate does not, he said.

The lawsuit (Cuccinelli v. Sebelius) was filed by Virginia attorney general Ken Cuccinelli, a Republican, on March 23, the day the president signed the ACA into law. The suit argues that the federal government does not have the authority under the "Commerce Clause" of the Constitution to force citizens to purchase health insurance.

"While this case raises a host of complex Constitutional issues, all seem to distill to the single question of whether Congress has the power to regulate -- and tax -- a citizen's decision not to participate in interstate commerce," Hudson wrote in an earlier decision in August, when he denied a request from the Obama administration to dismiss the lawsuit.

The courts have yet to address that issue, Hudson wrote.

Lawyers for the federal government have contested Cuccinelli's premise that a person can simply elect not to participate in the healthcare market.

Every person will likely seek medical care at some point, lawyers for the Obama administration argued, and if that person has no insurance, it's likely that their medical costs are absorbed by those with insurance, thus affecting commerce for a large number of people.

"No person can guarantee that he will divorce himself entirely from the market for healthcare services," the government lawyers have argued, saying that the decision to not purchase insurance is still considered a type of "economic activity."

But in a 42-page opinion issued today, Hudson rejected that theory, calling it overly broad.

"Neither the Supreme Court nor any federal circuit court of appeals has extended Commerce Clause powers to compel an individual to involuntarily enter the stream of commerce by purchasing a commodity in the private market," Hudson wrote.

Lawyers for the federal government have also argued that the individual mandate is necessary in order to enforce two crucial aspects of the law: barring insurance companies from denying coverage based on a preexisting medical condition and from charging higher premiums based on medical history.

If everyone isn't required to have insurance or else pay a penalty, the costs of covering those with expensive medical conditions would be too great, and the whole system would "implode," the Obama administration has said, citing another section of the Constitution known as the "Necessary and Proper Clause."

Hudson declined to comment on whether the rest of the law could actually work in the absence of the individual mandate.

In a small victory for the administration, though, he rejected Cuccinelli's request to invalidate the entire ACA, ruling that only the individual mandate and closely related sections of the law were affected by his decision.

The ruling comes a few days before a federal judge in Florida will hear oral arguments in a lawsuit brought by 20 other states against the law.

While there are many challenges to the ACA, the Florida and Virginia cases are considered most likely to make their way to the Supreme Court.

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